Introduction Few studies have investigated the East-West health discrepancy within young adults who were children during this era. We study this phenomenon and its context globally, by examining variations between world regions in personal health within generations. Socioeconomic influence is also investigated.

Methods World Health Survey data were analysed on adults aged 18-34 (n=91 823), and their elders aged 35+ (n=132 362). Main outcome was personal health. Main predictor variable was regions. Multilevel logistic regression was used to assess associations between personal health and regions, while accounting for individual and country-level socioeconomic factors.

Results Citizens of the Former Soviet Union reported the highest prevalence of poor health, globally with OR being 3.29 (95% CI 1.92 to 5.64). Central Europeans also had high odds of reporting poor health as compared to Western Europeans, but not to the global south, (OR)=1.66 (95% CI 1.07 to 2.55). Age analyses showed that a generation effect was apparent. After full adjustments of socioeconomic factors, East-West health differences were small within young adults, and became larger at each increasing age interval. This pattern was opposite for the global south.

Conclusion The East-West health gap is more pronounced within the Former Soviet Union citizens, rather than Central Europeans. Although the public health concern within these regions cannot be denied, it seems as though young adults might have been insulated to some extent from the ill-health effects of the political transition. Unlike their elders, they have come of age within the new regime, and might not feel as displaced from society.